The Strange World of Pruritus Ani

Pruritus Ani is characterised by an intense itching of the peri-anal skin and is estimated to affect 1-5% of the population. It is more common in men between the ages of 40 and 60 and there have been over 100 different causes given, including haemorrhoids and fissures.

Pruritus is a common term for itching and was first coined back in 1960. There are many forms of which pruritus ani is just one.

Research on this condition is sketchy because of the embarrassing nature of anal itching that patients are often not willing to confess to their GP or doctor. It is also often characterised as part of another more obvious condition such as a threadworm infection, itching during pregnancy or a stomach disorder.

  • Patients with loose stools are far more likely to suffer from pruritus ani which can be caused by faecal contamination. The problem can be solved by greater hygiene and keeping the rectal area dry.
  • 15% of pruritus ani cases not associated with any particular disease can be accounted for by fungal infections.
  • Various foods have been implicated in idiomatic pruritus ani, including caffeine, alcohol, milk, nuts, spices and tomatoes.
  • 52% of patients with pruritus ani have a co-existing problem, the most common being haemorrhoids which may add to sphincter dysfunction and faecal seepage.
  • Symptoms of pruritus ani can often be suffered for weeks or years before a person will go to their doctor to seek medical advice.

Often a soothing natural anal cream and keeping the area clean and dry will help with this embarrassing problem but if symptoms persist, as they may do if the underlying condition is more serious, it is best to go and see your doctor to have a full examination.

The Strange Case of Balsam of Peru

Used in food and drink flavouring, in cosmetics, and also in medicines, Balsam of Peru is derived from the Myroxyion tree in South America.  It is even used in some haemorrhoid treatments. The problem is that some people are allergic to it and this can manifest itself in the form of contact dermatitis or pruritus which can be the cause of anal itching or irritation.

Avoiding the Itch Scratch Cycle

There is some belief that a condition like pruritus ani may be prolonged by our urge to scratch that itch. Some experts believe that if we resist that urge then the irritability may pass pretty quickly but that scratching can cause the release of inflammatory chemicals that cause the opposite effect.

Why Scratching that Itch Feels so Good

Scientists recently took a look at which part of the brain is involved when we scratch an itch. They found that it wasn’t limited to a small area but involved sections that are involved with reward, motivation, pleasure and craving. And scratching it yourself works better than someone else doing it for you.

It’s true that pruritus ani can cover a wide range of conditions that cause anal irritation as part of their symptoms, and while, for many people, it is just a question of applying a soothing cream, for others it could and should mean a trip to the doctors just to find out what is really going on.

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